Adenomyosis is a condition that causes many symptoms—like pelvic pain and heavy bleeding—that mimic fibroid symptoms. This condition is the result of endometrial cells (from the uterine inner lining) that migrate into the middle, muscular wall of the uterus, the myometrium, where they stay put. The newly lodged cells then increase the mass of your uterus.
What Causes Adenomyosis?
Unfortunately, we still don’t understand the exact cause of this condition, although different the
ories exist. One suggests that it’s caused by genetic changes in endometrial cells. Another proposes that, in fact, cells inside your myometrium actually convert into endometrial cells. We also believe that hormones like estrogen trigger the condition since its symptoms go away after menopause. Female levels of estrogen go down in the first year after menopause and the symptoms dissipate as well.
How is Adenomyosis Diagnosed?
This condition is sometimes diagnosed with an ultrasound scan, but it can be difficult to spot lodged cells, so an MRI is often needed for confirmation. Often, adenomyosis is detected while your doctor is screening for fibroid tumors.
What Are the Symptoms of Adenomyosis?
While a good portion of women—as many as 30%–won’t experience any symptoms, women with adenomyosis typically experience:
- Heavy bleeding
- Intense pelvic pain and pressure
- Pain that radiates to your legs and back
- Distended stomach
- Blood clots in the pelvis and legs
- Prolonged menstrual cycles
- Spotting between cycles
There’s one more important symptom you need to know about: adenomyosis can impact your fertility. This is especially true if you’re attempting to get pregnant through IVF (In-vitro fertilization.) That’s because adenomyosis can interfere with embryo implantation. And, if you do become pregnant, it can also increase your risk of miscarrying.
How do we treat Adenomyosis?
The only way to cure this condition is to undergo a hysterectomy. For many women, this will be too drastic an option—especially since we now know that hysterectomies leave women at risk for cardiac and metabolic problems.
So, while we can’t stop the problem without removing your uterus, we can help manage symptoms with less invasive treatment options. The best option for you will depend on the severity of your symptoms and your overall health:
- Anti-inflammatory medications like ibuprofen can help with the pain and reduce the blood flow. For best results, start taking medication several days prior to the start of your cycle.
- Taking birth control pills and other hormonal supplements can help manage the condition.
- Endometrial Ablation is a minimally invasive procedure that destroys the uterine lining, so no cells can migrate into the muscle wall. The success of this option will depend on how deeply endometrial tissue has penetrated into the wall of your uterus.
- UAE or Uterine Artery Embolization. We use this technique commonly used to treat uterine fibroids, but it can help adenomyosis, too. Here, we inject particles into the uterine artery, blocking blood flow to the problem area. We do this to deprive your tissue of blood and oxygen, helping stop adenomyosis’ progression. But, unlike UFE for fibroid treatments, when you have UAE for adenomyosis, you have to spend the night in the hospital. As we evolve our technique, UAE has earned an 80% effectiveness rating in abating the symptoms of adenomyosis, making it an excellent short term solution to this painful condition.
Sources: Journal of Clinical and Experimental Reproductive Medicine